Medicine and Health Sciences Commons^™

Methemoglobin And Nitric Oxide Therapy In Ugandan Children Hospitalized For Febrile Illness: Results From A Prospective Cohort Study And Randomized Double-Blind Placebo-Controlled Trial, Andrea Conroy, Michael Hawkes, Kyla Hayford, Laura Hermann, Chloe Mcdonald, Suparna Sharma, Sophie Namasopo, Robert Opoka, Chandy John, Conrad Liles

Paediatrics and Child Health, East Africa

Background: Exposure of red blood cells to oxidants increases production of methemoglobin (MHb) resulting in impaired oxygen delivery to tissues. There are no reliable estimates of methemoglobinemia in low resource clinical settings. Our objectives were to: i) evaluate risk factors for methemoglobinemia in Ugandan children hospitalized with fever (study 1); and ii) investigate MHb responses in critically ill Ugandan children with severe malaria treated with inhaled nitric oxide (iNO), an oxidant that induces MHb in a dose-dependent manner (study 2).

Methods: Two prospective studies were conducted at Jinja Regional Referral Hospital in Uganda between 2011 and 2013. Study 1, a …

Comparison Of The Prevalence And Characteristics Of Inpatient Adverse Events Using Medical Records Review And Incident Reporting, William Macharia, Charles Muteshi, Sikolia Wanyonyi, Abraham Mukaindo, Ahmed Ismail, Herman Ekea, Abdallah Abdulkarim, John Tole, Anthony Ngugi

Paediatrics and Child Health, East Africa

No abstract provided.

World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Vitamin D, Juan José Yepes-Nuñez, Alessandro Fiocchi, Ruby Pawankar, Carlos A. Cuello-Garcia, Yuan Zhang, Gian Paolo Morgano, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Shreyas Gandhi, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda, Susan Waserman, Holger J. Schünemann, Jan L. Brożek

Paediatrics and Child Health, East Africa

Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20–30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases.

Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of vitamin D in primary prevention of allergic diseases.

Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a …

Effect Of Provision Of An Integrated Neonatal Survival Kit And Early Cognitive Stimulation Package By Community Health Workers On Developmental Outcomes Of Infants In Kwale County, Kenya: Study Protocol For A Cluster Randomized Trial, Lisa G. Pell, Diego G. Bassani, Lucy Nyaga, Isaac Njagi, Catherine Wanjiku, Thulasi Thiruchselvam, William Macharia, Ripudaman S. Minhas, Patricia Kitsao-Wekulo, Amyn Lakhani, Zulfiqar Ahmed Bhutta, Robert Armstrong, Shaun K. Morris

Paediatrics and Child Health, East Africa

Background: Each year, more than 200 million children under the age of 5 years, almost all in low- and middle-income countries (LMICs), fail to achieve their developmental potential. Risk factors for compromised development often coexist and include inadequate cognitive stimulation, poverty, nutritional deficiencies, infection and complications of being born low birthweight and/or premature. Moreover, many of these risk factors are closely associated with newborn morbidity and mortality. As compromised development has significant implications on human capital, inexpensive and scalable interventions are urgently needed to promote neurodevelopment and reduce risk factors for impaired development.

Method/Design: This cluster randomized trial aims at …

The Impact And Successes Of A Paediatric Endocrinology Fellowship Program In Africa, Gordon Otieno Odundo, Thomas Ngwiri, Olivia Otuoma, Paul Laigong, Renson Mukhwana, Mary Limbe, Nadia Musimbi Chanzu

Paediatrics and Child Health, East Africa

Background: The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology.

Methods: The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow’s home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are …

Population Health Science: A Core Element Of Health Science Education In Sub-Saharan Africa, Robert A. Hiatt, Natalie J. Engmann, Mushtaq Ahmed, Yasmin Amarsi, William Macharia, Sarah B. Macfarlane, Anthony Ngugi, F. Rabbani, Gijs Walraven, Robert Armstrong

Paediatrics and Child Health, East Africa

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches. A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical …

Association Of Caregiver Quality Of Care With Neurocognitive Outcomes In Hiv-Affected Children Aged 2–5 Years In Uganda, Judith Bass, Noeline Nakasujja, Itziar Familiar-Lopez, Alla Sikorskii, Sarah Murray, Robert Opoka, Jura Augustinavicius, Michael Boivin

Paediatrics and Child Health, East Africa

Abstract: Children affected by HIV are at increased risk of developmental and neuropsychological disturbances due to direct effects of HIV on the brain and direct effects associated with living in poverty. Caregivers can play an important role, through quality caregiving, in mitigating the negative effect of these stressors. This study used baseline data from an ongoing caregiver training intervention trial to evaluate the association between quality of caregiver-child interactions and neurocognitive outcomes in rural HIV-infected and HIV-exposed but uninfected children in Uganda. We also assessed the extent to which caregiver distress moderated this relationship. Data on 329 caregiver-child dyads were …

A Pre-Post Study Of A Multi-Country Scale Up Of Resuscitation Training Of Facility Birth Attendants: Does Helping Babies Breathe Training Save Lives?, Roopa M. Bellad, Akash Bang, Waldemar A. Carlo, Elizabeth M. Mcclure, Sreelatha Meleth, Norman Goco, Shivaprasad S. Goudar, Richard J. Derman, Patricia L. Hibberd, Archana Patel, Fabian Esamai, Sherri Bucher, Peter Gisore, Linda L. Wright

Paediatrics and Child Health, East Africa

Background: Whether facility-based implementation of Helping Babies Breathe (HBB) reduces neonatal mortality at a population level in low and middle income countries (LMIC) has not been studied. Therefore, we evaluated HBB implementation in this context where our study team has ongoing prospective outcome data on all pregnancies regardless of place of delivery.

Methods: We compared outcomes of birth cohorts in three sites in India and Kenya pre-post implementation of a facility-based intervention, using a prospective, population-based registry in 52 geographic clusters. Our hypothesis was that HBB implementation would result in a 20 % decrease in the perinatal mortality rate (PMR) …

Setting Research Priorities To Improve Global Newborn Health And Prevent Stillbirths By 2025, Sachiyo Yoshida, José Martines, Peter Gisore, Joy E. Lawn, Stephen Wall, Joăo Paulo Souza

Paediatrics and Child Health, East Africa

Background: In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013–2025.

Methods: We used adapted Child …

Self-Reported Practices Among Traditional Birth Attendants Surveyed In Western Kenya: A Descriptive Study, Sherri Bucher, Olive Konana, Edward Liechty, Ana Garces, Peter Gisore, Irene Marete, Constance Tenge, Evelyn Shipala, Linda Wright, Fabian Esamai

Paediatrics and Child Health, East Africa

Background: The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help …